Evidence map›Paper›PMID 39302447›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

Trends in inpatient versus outpatient upper extremity fracture surgery from 2008 to 2021 and their implications for equitable access: a retrospective cohort study.

Clay B Beagles, Ian T Watkins, Aron Lechtig, Philip Blazar, Neal C Chen, Jonathan Lans

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Clay B BeaglesDepartment of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. clay_beagles@hms.harvard.edu.ORCID http://orcid.org/0000-0001-6062-7495
Ian T WatkinsHarvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Aron LechtigHarvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Philip BlazarDepartment of Orthopaedic Surgery, Hand and Upper Extremity Service, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Neal C ChenDepartment of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jonathan LansHarvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this study is to describe trends in inpatient and outpatient upper extremity fracture surgery between 2008 and 2021, along with identifying patient factors (age, sex, race, socioeconomic status) associated with outpatient surgery.

methodsRetrospectively, 12,593 adult patients who underwent upper extremity fracture repair from 2008 to 2021 at one of five urban hospitals in the Northeastern USA were identified. Using Distressed Communities Index (DCI), patients were divided into five quintiles based on their level of socioeconomic distress. Multivariable logistic regression was performed on patients from 2008 to 2019 to identify independent factors associated with outpatient management.

resultsFrom 2008 to 2019, outpatient procedures saw an average increase of 31%. The largest increases in the outpatient management were seen in humerus (132%) and forearm fractures (127%). Carpal and hand surgeries had the lowest percent increase of 8.1%. Clavicle and wrist fractures were independently associated with outpatient management. Older age, male sex, higher Elixhauser comorbidity index, DCI scores in the 4th or 5th quintile, and fractures of the scapula, humerus, elbow, and forearm were associated with inpatient management. During the onset of the COVID-19 pandemic, there was a decrease in outpatient procedures.

conclusionThere is a shift toward outpatient surgical management of upper extremity fractures from 2008 to 2021. Application of our findings can serve as an institutional guide to allocate patients to appropriate surgical settings. Moreover, physicians and institutions should be aware of the potential socioeconomic disparities and implement plans to allow for equal access to care.

Indexed as

Ambulatory Surgical ProceduresFractures, BoneAdultAgedCOVID-19FemaleHealthcare DisparitiesHealth Services AccessibilityHumansMaleMiddle AgedRetrospective StudiesUpper ExtremityAmbulatoryOutpatientSocial determinants of healthTrendsUpper extremity

Identifiers

PMID39302447

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.